Expectations and final evaluation of complete dentures by patients, dentist and dental technician

There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207). and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.

Takayasu's arteritis: What should the dentist know?

Takayasu's arteritis is a chronic inflammatory disease that affects large blood vessels, especially the aorta and/or its major branches. The condition presents with segmental lesions adjacent to normal, apparently unaffected, areas. The lesions include stenosis, occlusion, dilatations or aneurysm formations along the path of the affected artery. Because of the severity of the disease and the possibility of cardiovascular complications, patients with Takayasu's arteritis require medical treatment based on immunosuppressive and antihypertensive drugs, as well as regular follow up and surgical intervention in many instances. The aim of this paper was to describe the characteristics of Takayasu's arteritis, to report dental treatment carried out on an affected patient, and to discuss the main implications and care required during routine treatment for children in the dental office. © 2005 BSPD and IAPD.

The importance of a good relationship between patient/dentist based on the obtaining of an informed consenr to prevent lawsuits

The increased number of law suits in the Dentistry field constitutes an international trend. Patients well informed by the media and supported by the law sue their dentists, when they judge they were victim of bad practice. Professionals even with all discussion about this subject do not have the habit of prevent themselves. It is known that for a defensive practice the best way to avoid litigation is a good relationship with patient, based on dialog and on informed consent. This relation is very important, since patients who rely on their dentists rarely take them to justice. Hence, this article discusses the importance of this relation, as well as the obtaining of informed consent in order to prevent lawsuits.

Ergonomics work analysis applied to dentistry - a Brazilian case study

This paper presents the Ergonomic Work Analysis method in a Brazilian Dentist's office. Through the study, the constraints and the strategies in avoiding them were identified. It was found that dentists hardly use the position most indicated by the International Organization for Standardization (ISO) and the Federation Dentaire Internacionale (FDI) for both the patient and the dentist, which is respectively supine and 9 o'clock, due to the limited space and layout. Five types of treatments performed by the professional have been studied. The frequency and duration of actions in these treatments were accounted for and the standard positions adopted were identified. The AET was found to be a very suitable method to grasp the dentist's activity and build a point of view of the profession, which is characterized as: stressful, perfectionist and restrictive. Time management is presented as an important strategy to control the tension arising from performing the treatments.

Dental Implants in Patients With Osteoporosis: A Clinical Reality?

Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density. Dental implantology is a specialty with high predictability when both quantity and quality of the bone are respected. Therefore, the diagnosis and the implant treatment in patients with osteoporosis are important. In the current study, a literature review about osteoporosis and dental implant therapy was conducted. PubMed, Cochrane, ISI, Dentistry Oral Science, SciELO, and Bireme databases were consulted over the last 20 years. English- and Portuguese-language articles were included in this revision. Some authors stated that the osteoporotic bone is similar to the proposed model of bone type IV. Randomized clinical studies reported implant failure in patients with osteoporosis after menopause. Studies that contraindicate the use of implants in patients with osteoporosis infer that the impaired bone metabolism led to reduction of bone healing around the implants. Nevertheless, other authors believe that the presence of osteoporosis is not a definitive condition to contraindicate the therapy with dental implants. In these cases, the dentist should perform a proper treatment planning, modifying the implant geometry, and use larger implant diameter and with surface treatment. Thus, osteoporosis is not a contraindication for implant surgery because an accurate analysis of bone quality by means tomography is performed.

Evaluating the knowledge of sports participants regarding dental emergency procedures

Dental trauma is a common consequence of sports practice to which emergency treatment is critical. The purpose of this study was to evaluate the knowledge of sports participants about dental trauma procedures, particularly tooth avulsion. A specific questionnaire concerning concepts, experiences and behaviors after dental trauma and the use of mouthguard was standardized and validated with 80 people. The validated questionnaire was then distributed to 310 sports participants. The results showed that 28.4% had experienced a kind of dental trauma; 42.6% would look for a dentist for treatment; 51.7% reimplanted or would reimplant the avulsed tooth; 6.5% would maintain the avulsed tooth in milk. Although 47.4% of the participants were aware of the possibility of accidents during sports practice, only 13.9% reported to use a mouthguard. This study showed an overall lack of knowledge of sportsmen and sportswomen with regards to tooth avulsion, thus reinforcing the need for educational campaigns to improve the immediate emergency treatment of tooth avulsion.

Removable Partial Denture in Combination with a Milled Fixed Partial Prosthesis as Interim Restorations in Long-Term Treatment

Interim restorations are frequently used in prosthodontic treatments. Many complex situations require the combination of fixed and removable partial prostheses. An appropriate interim restoration design that accurately implements the treatment plan is necessary to prepare the oral cavity for the prostheses, and to contribute to the preservation and health of remaining natural teeth, bone support, and gingival tissues. This report describes a modified technique for construction of interim restorations with a combination of fixed and removable partial prostheses. The technique consists of the construction of a milled fixed prosthesis and removable partial denture with metallic framework for use during extensive treatment, improving masticatory function and esthetics and preserving the periodontal health of supporting structures. This interim restoration can also serve as a template for the definitive restoration, allowing patient and dentist to evaluate appearance and function and helping to ensure the success of the definitive restoration.

Photoelastic Analysis of Stress Distribution in Oral Rehabilitation

The purpose of this study was to present a literature review about photoelasticity, a laboratory method for evaluation of implants prosthesis behavior. Fixed or removable prostheses function as levers on supporting teeth, allowing forces to cause tooth movement if not carefully planned. Hence, during treatment planning, the dentist must be aware of the biomechanics involved and prevent movement of supporting teeth, decreasing lever-type forces generated by these prosthesis. Photoelastic analysis has great applicability in restorative dentistry as it allows prediction and minimization of biomechanical critical points through modifications in treatment planning.

Mobility, Aesthetic, Implants, and Satisfaction of the Ocular Prostheses Wearers

During the process of facial rehabilitation, the mobility of ocular prostheses must be considered. Whereas some factors depend exclusively on the dentist, such as molding techniques and selection of material for denture construction, regarding ocular rehabilitation, factors, such as type of surgery, whether to adopt implants, and the use of lubricants, deserve special attention owing to their integration and their association with other factors pertaining exclusively to the patient. To establish harmony, and with the intention of aiding the dentist, after a discerning evaluation, the authors of this study report the factors that provide greater or less mobility to ocular prostheses and conceal the prosthesis in a more natural way, thereby contributing toward achieving a favorable aesthetic result in rehabilitations.

Análise do conhecimento de professores de Educação Infantil sobre saúde bucal

A figura do professor exerce grande influência sobre o comportamento dos alunos, pelo contato diário durante longo tempo. O objetivo do presente trabalho foi analisar o conhecimento dos professores de escolas estaduais e municipais de educação infantil no que diz respeito à saúde bucal. Foi realizado um estudo exploratório descritivo, com abordagem quanti-qualitativa com 164 professores, utilizando-se um questionário, autoaplicável, com perguntas sobre o tema. Os mesmos foram digitados e analisados pelo programa Epi Info, 3.5.1. Entre os resultados obtidos, pode-se observar que 94,5% relataram atuar em escolas que possuem atividades de educação em saúde bucal. Sobre as informações a respeito dos cuidados necessários para a manutenção da saúde bucal, 85,4% relataram ter recebido em algum momento. Segundo eles, a informação foi fornecida principalmente pelo cirurgião dentista (64,3%), alunos FOA-UNESP (16,4%), família (5,7%). 95,7% responderam saber o que é cárie dentária. Dentre esses indivíduos, 12,2% relacionaram-na a resíduos acumulados no dente. No que se refere à função do flúor em relação à cárie dentária, 88,4% indicaram conhecê-la. Destes, 50,3% atribuíram ao mesmo a função de proteção da estrutura dental. Pode-se concluir que embora a escola seja um espaço importante de informação, esta é ainda muito pouco aproveitada, os professores possuem pouco conhecimento a respeito dos cuidados necessários para a manutenção da saúde bucal e necessitam de maiores informações para abordarem com segurança estes temas em sala de aula.

Dentistry in Brazil: Its History and Current Trends

The objectives of this article are to provide a short history of dentistry and dental education in Brazil and to analyze the nature of its development to date. The databases consulted are those provided by the Brazilian Federal Council of Dentistry, Brazilian Ministry of Health, Brazilian Ministry of Education, National Institute of Studies and Educational Research Anisio Teixeira, and Brazilian Institute of Geography and Statistics. Formal dental education in Brazil started in the late nineteenth century with the creation of courses annexed to existing schools of medicine in Rio de Janeiro and Bahia. Today, there are 191 institutions of higher education nationwide granting degrees in dentistry (137 private [71.7 percent] and fifty-four public [28.3 percent]), with a total of 17,157 student positions offered annually. These schools graduate around 10,000 professionals per year-one of the highest rates in the world. Both the distribution of schools of dentistry and of dentists varies among the regions of the country, with the greatest concentrations in major metropolitan centers with high population density, resulting in limited coverage in the more deprived regions. A review of epidemiological data for oral health and distribution of dentists in Brazil indicates that there is a lack of systematic planning for the allocation of the dental workforce and a lack of consideration of regional needs in the development of dental training programs in Brazil today.

Shortening of primary dentin etching time and its implication on bond strength

Objective. The aim of this study was to investigate the influence of shortening the etching time on the bond strength of a conventional and a self-etching primer adhesive system used in primary tooth dentin.Methods. Flat dentin surfaces were obtained from 24 primary molars, randomly assigned to 4 experimental groups. The adhesive systems Single Bond and Clearfil SE Bond were applied in two groups according to the manufacturers' recommendations. In the other two groups, the adhesives were applied after half-time of acid etching, 7 s for Single Bond and 10 s for Clearfil SE Primer. Resin crowns were built up and after 24 h storage in water at 37 &DEG; C, the teeth were sectioned to produce beams with cross-sectional area of approximately 0.49 mm(2). Specimens were tested in tension at 0.5 mm/min until failure. Fractured specimens were analyzed to determine the failure mode.Results. Tensile bond strengths for Single Bond in primary dentin were higher than for Clearfil SE Bond. Shortening of acid etching time improved bond strength only for Single Bond, while no statistically significant difference was observed for Clearfil SE Bond when both etching times were compared.Significance. No detrimental effect on bond strength was observed when the time of acid etching was shortened in 50%. Shortening the time for a procedure in a small child without compromising the quality of the work is a very important finding for the practicing pediatric dentist. © 2004 Elsevier Ltd. All rights reserved.